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Fu J, Lin Q, Ai B, Li M, Luo W, Huang S, Yu H, Yang Y, Lin H, Wei J, Su X, Zhang Z. Associations between maternal exposure to air pollution during pregnancy and trajectories of infant growth: A birth cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 269:115792. [PMID: 38064789 DOI: 10.1016/j.ecoenv.2023.115792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE We examined the relationships between infants' growth trajectories and prenatal exposure to air pollution, which is still under-investigated. METHODS A birth cohort study was constructed using medical records of pregnant women and infants born between 2015 and 2019 in Foshan, China. Using satellite-based spatial-temporal models, prenatal exposure to air pollutants including particulate matter with an aerodynamic dimension of < 2.5 µm (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) was assessed at each woman's residence. Latent class growth modeling was used to identify trajectories of physical (body length and weight) growth and neurodevelopment, which were repeatedly measured within 1 year after birth. Logistic regression models were used to investigate the associations between prenatal exposure to air pollution and the risks of growth disorders, adjusting for an array of potential confounders. RESULTS We identified two growth trajectories for body length [normal: 3829 (93%); retardation: 288 (7%)], three for weight [normal: 2475 (59.6%); retardation: 390 (9.4%); overgrowth: 1287 (31%)], and two for neurodevelopment [normal: 956 (66.1%); retardation: 491 (33.9%)]. For exposure over whole pregnancy, SO2 was associated with an increased risk of body length retardation (OR for per 1 µg/m3 increment: 1.09, 95%CI: 1.01-1.17); PM2.5 (OR: 1.05, 95%CI: 1.03-1.07), SO2 (OR: 1.15, 95%CI: 1.08-1.22), and NO2 (OR: 1.05, 95%CI: 1.03-1.07) were positively associated with neurodevelopmental retardation. Such associations appeared stronger for exposures over the first and second trimesters. No significant associations were detected for weight growth. CONCLUSIONS Maternal exposure to air pollution during pregnancy was associated with higher risks of impairments in both physical growth, particularly body length, and neurodevelopment.
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Affiliation(s)
- Jiaying Fu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qingmei Lin
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Baozhuo Ai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meijun Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weidong Luo
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Saijun Huang
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Hong Yu
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Wei
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China; Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Xi Su
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China.
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Wei J, Wang T, Song X, Liu Y, Shu J, Sun M, Diao J, Li J, Li Y, Chen L, Zhang S, Huang P, Qin J. Association of maternal methionine synthase reductase gene polymorphisms with the risk of congenital heart disease in offspring: a hospital-based case-control study. J Matern Fetal Neonatal Med 2023; 36:2211201. [PMID: 37183022 DOI: 10.1080/14767058.2023.2211201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Evidence suggests that periconceptional folic acid supplementation may prevent congenital heart disease (CHD). Methionine synthase reductase (MTRR) is one of the key regulatory enzymes in the folate metabolic pathway. This study aimed to comprehensively evaluate the association of single nucleotide polymorphisms (SNPs) in the maternal MTRR gene with CHD risk in offspring. METHODS A hospital-based case-control study involving 740 mothers of CHD cases and 683 health controls was conducted. RESULTS The study showed that maternal MTRR gene polymorphisms at rs1532268 (C/T vs. C/C: aOR = 1.524; T/T vs. C/C: aOR = 3.178), rs1802059 (G/A vs. G/G: aOR = 1.410; A/A vs. G/G: aOR = 3.953), rs2287779 (G/A vs. G/G: aOR = 0.540), rs16879334 (C/G vs. C/C: aOR = 0.454), and rs2303080 (T/A vs. T/T: aOR = 0.546) were associated with the risk of CHD. And seven haplotypes were observed to be associated with the risk of CHD, T-G-A haplotype (OR = 1.298), C-A-C-C (OR = 4.824) and A-G haplotype (OR = 1.751) were associated with increased risk of CHD in offspring; A-A-A (OR = 0.773), T-A-A (OR = 0.557), G-A-C-C (OR = 0.598) and G-C (OR = 0.740) were associated with decreased risk of CHD in offspring. CONCLUSIONS Maternal MTRR gene polymorphisms were associated with CHD in offspring, and its haplotypes have affected the occurrence of CHD. Furthermore, given the complexity and heterogeneity of CHD, the mechanisms by which these factors influence offspring cardiac development remain unknown, and studies in larger samples in an ethnically diverse population are needed.
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Affiliation(s)
- Jianhui Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Xinli Song
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yiping Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jing Shu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Mengting Sun
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jingyi Diao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jingqi Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yihuan Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Letao Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Senmao Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Peng Huang
- Hunan Children's Hospital, Changsha, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
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Wang H, Ruan YP, Ma S, Wang YQ, Wan XY, He YH, Li J, Zou ZY. Interaction between ozone and paternal smoking on fetal congenital heart defects among pregnant women at high risk: a multicenter maternal-fetal medicine study. World J Pediatr 2023:10.1007/s12519-023-00755-1. [PMID: 37665504 DOI: 10.1007/s12519-023-00755-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Evidence remains limited on the association between maternal ozone (O3) exposure and congenital heart defects (CHDs) in offspring, and few studies have investigated the interaction and modification of paternal smoking on this association. METHODS Using a sample including pregnant women at high risk of fetal CHD (with metabolic disease, first-trimester viral infection, family history of CHD, etc.) from a maternal-fetal medicine study covering 1313 referral hospitals in China during 2013-2021, we examined the associations between maternal O3 exposure during 3-8 weeks of gestational age and fetal CHD in offspring and investigated the interaction and modification of paternal smoking on this association. CHD was diagnosed by fetal echocardiograms, maximum daily 8-hour average O3 exposure data at a 10 km × 10 km spatial resolution came from the Tracking Air Pollution in China dataset, and paternal smoking was collected using questionnaires. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Among 27,834 pregnant women at high risk of fetal CHD, 17.4% of fetuses were diagnosed with CHD. Each 10 μg/m3 increase in maternal O3 exposure was associated with a 17% increased risk of CHD in offspring (OR = 1.17, 95% CI = 1.14-1.20). Compared with paternal nonsmoking and maternal low O3 exposure, the ORs (95% CI) of CHD for smoking and low O3 exposure, nonsmoking and high O3 exposure, and smoking and high O3 exposure were 1.25 (1.08-1.45), 1.81 (1.56-2.08), and 2.23 (1.84-2.71), respectively. Paternal smoking cessation seemingly mitigated the increased risk of CHD. CONCLUSIONS Maternal O3 exposure and paternal smoking were interactively associated with an increased risk of fetal CHD in offspring, which calls for effective measures to decrease maternal exposure to O3 pollution and secondhand smoke for CHD prevention.
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Affiliation(s)
- Huan Wang
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Yan-Ping Ruan
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University; Maternal-Fetal Medicine center in Fetal Heart Disease, Beijing Anzhen Hospital, No. 2 Anzhen Rd, Chaoyang District, Beijing, 100029, China
| | - Sheng Ma
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Ya-Qi Wang
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Xiao-Yu Wan
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Yi-Hua He
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University; Maternal-Fetal Medicine center in Fetal Heart Disease, Beijing Anzhen Hospital, No. 2 Anzhen Rd, Chaoyang District, Beijing, 100029, China.
| | - Jing Li
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Zhi-Yong Zou
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.
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Chang YC, Lin YT, Jung CR, Chen KW, Hwang BF. Maternal exposure to fine particulate matter and congenital heart defects during preconception and pregnancy period: A cohort-based case-control study in the Taiwan maternal and child health database. ENVIRONMENTAL RESEARCH 2023; 231:116154. [PMID: 37187309 DOI: 10.1016/j.envres.2023.116154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/21/2023] [Accepted: 05/13/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Few studies have explored the association between maternal exposure to particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) and congenital heart defects occurring before and during pregnancy. We aimed to investigate the association and the critical time windows between the maternal exposure to PM2.5 and congenital heart defects. METHOD We conducted a cohort-based case-control study of 507,960 participants obtained from the Taiwan Maternal and Child Health Database between 2004 and 2015. We applied satellite-based spatiotemporal models with 1-km resolution to calculate the average PM2.5 concentration during preconception and the specific periods of pregnancy. We also performed conditional logistic regression with distributed lag non-linear models (DLNMs) to assess the effects of weekly average PM2.5 on both congenital heart defects and their isolated subtypes, as well as the concentration-response relationships. RESULTS In DLNMs, exposure to PM2.5 (per 10 μg/m3) during weeks 7-12 before conception and weeks 3-9 after conception was associated with congenital heart defects. The strongest association at 12 weeks before conception (odds ratio [OR] = 1.026, 95% confidence intervals [CI]: 1.012-1.040) and 7 weeks after conception (OR = 1.024, 95% CI: 1.012-1.036) for every 10 μg/m3 increase in PM2.5 concentration. In modification analysis, strongest associations were observed for low SES. CONCLUSIONS Our study revealed that exposure to ambient PM2.5 raises the risk of congenital heart defects, particularly among individuals with lower socioeconomic status. Moreover, our findings suggest that preconception exposure to PM2.5 may be a crucial period for the development of congenital heart defects.
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Affiliation(s)
- Ya-Chu Chang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Yu-Ting Lin
- Big Data Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.
| | - Chau-Ren Jung
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Japan Environment and Children's Study Programme Office, Health and Environmental Risk Division, National Institute for Environmental Studies, Tsukuba, Japan
| | - Ke-Wei Chen
- Division of Cardiovascular Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Bing-Fang Hwang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Agay-Shay K. Invited Perspective: Air Pollution and Congenital Heart Defects (CHDs)-a Summary of Two Decades and Future Direction in Research. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:61305. [PMID: 37339065 DOI: 10.1289/ehp12931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Affiliation(s)
- Keren Agay-Shay
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Buteau S, Veira P, Bilodeau-Bertrand M, Auger N. Association between First Trimester Exposure to Ambient PM2.5 and NO2 and Congenital Heart Defects: A Population-Based Cohort Study of 1,342,198 Live Births in Canada. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:67009. [PMID: 37339064 PMCID: PMC10281560 DOI: 10.1289/ehp11120] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND The extent to which ambient air pollution contributes to the pathogenesis of congenital heart defects remains uncertain. OBJECTIVE We investigated whether first trimester exposure to ambient fine particulate matter (PM2.5) and nitrogen dioxide (NO2) was associated with the risk of critical and noncritical heart defects in a large population-based cohort of births. METHODS We carried out a retrospective cohort study of children conceived between 2000 and 2016 in Quebec, Canada. Heart defects were identified via data from the Maintenance and Use of Data for the Study of Hospital Clientele registry. The main exposures were average concentration of PM2.5 and NO2 in a) the first trimester and b) the month of conception. Exposures were estimated at the residential postal code. Associations with critical and noncritical heart defects were assessed using logistic regression models, adjusted for maternal and infant characteristics. We considered single- and two-pollutant models and assessed modifying effects of maternal comorbidity, including preexisting hypertension, preeclampsia, anemia, and diabetes. RESULTS The cohort comprised 1,342,198 newborns, including 12,715 with heart defects. Exposure in the first trimester and month of conception yielded similar results; both were associated with a greater risk of heart defects. Adjusted odds ratios (OR) for any heart defect per interquartile range increase were 1.02 (95% CI: 1.00, 1.05) for PM2.5 and 1.10 (95% CI: 1.07, 1.13) for NO2. Associations with atrial septal defects were 1.08 (95% CI: 1.03, 1.14) for PM2.5 and 1.19 (95% CI: 1.12, 1.25) for NO2. Corresponding ORs for ventricular septal defects and individual critical heart defects were not significant. PM2.5 (OR=1.11; 95% CI: 1.06, 1.17) and NO2 (OR=1.23; 95% CI: 1.17, 1.31) exposure were associated with a greater risk of heart defects in mothers with comorbidity. DISCUSSION In this population-based cohort, prenatal exposure to ambient air pollution during the first trimester was associated with an increased risk of heart defects, particularly atrial septal defects. The association with heart defects was greater in mothers with comorbidity. https://doi.org/10.1289/EHP11120.
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Affiliation(s)
- Stéphane Buteau
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Paige Veira
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Quebec, Canada
| | | | - Nathalie Auger
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Quebec, Canada
- University of Montreal Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
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Guo J, Chai G, Song X, Hui X, Li Z, Feng X, Yang K. Long-term exposure to particulate matter on cardiovascular and respiratory diseases in low- and middle-income countries: A systematic review and meta-analysis. Front Public Health 2023; 11:1134341. [PMID: 37056647 PMCID: PMC10089304 DOI: 10.3389/fpubh.2023.1134341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundLong-term exposure to particulate matter (PM) has essential and profound effects on human health, but most current studies focus on high-income countries. Evidence of the correlations between PM and health effects in low- and middle-income countries (LMICs), especially the risk factor PM1 (particles < 1 μm in size), remains unclear.ObjectiveTo explore the effects of long-term exposure to particulate matter on the morbidity and mortality of cardiovascular and respiratory diseases in LMICs.MethodsA systematic search was conducted in the PubMed, Web of Science, and Embase databases from inception to May 1, 2022. Cohort studies and case-control studies that examine the effects of PM1, PM2.5, and PM10 on the morbidity and mortality of cardiovascular and respiratory diseases in LMICs were included. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Outcomes were analyzed via a random effects model and are reported as the relative risk (RR) with 95% CI.ResultsOf the 1,978 studies that were identified, 38 met all the eligibility criteria. The studies indicated that long-term exposure to PM2.5, PM10, and PM1 was associated with cardiovascular and respiratory diseases: (1) Long-term exposure to PM2.5 was associated with an increased risk of cardiovascular morbidity (RR per 1.11 μg/m3, 95% CI: 1.05, 1.17) and mortality (RR per 1.10 μg/m3, 95% CI: 1.06, 1.14) and was significantly associated with respiratory mortality (RR 1.31, 95% CI: 1.25, 1.38) and morbidity (RR 1.08, 95% CI: 1.02, 1.04); (2) An increased risk of respiratory mortality was observed in the elderly (65+ years) (RR 1.21, 95% CI: 1.00, 1.47) with long-term exposure to PM2.5; (3) Long-term exposure to PM10 was associated with cardiovascular morbidity (RR 1.07, 95% CI 1.01, 1.13), respiratory morbidity (RR 1.43, 95% CI: 1.21, 1.69) and respiratory mortality (RR 1.28, 95% CI 1.10, 1.49); (4) A significant association between long-term exposure to PM1 and cardiovascular disease was also observed.ConclusionsLong-term exposure to PM2.5, PM10 and PM1 was all related to cardiovascular and respiratory disease events. PM2.5 had a greater effect than PM10, especially on respiratory diseases, and the risk of respiratory mortality was significantly higher for LMICs than high-income countries. More studies are needed to confirm the effect of PM1 on cardiovascular and respiratory diseases.
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Affiliation(s)
- Juanmei Guo
- School of Management, Lanzhou University, Lanzhou, China
| | - Guorong Chai
- School of Management, Lanzhou University, Lanzhou, China
- *Correspondence: Guorong Chai
| | - Xuping Song
- Evidence-based Social Sciences Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
- Xuping Song
| | - Xu Hui
- Evidence-based Social Sciences Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Zhihong Li
- Evidence-based Social Sciences Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xiaowen Feng
- Evidence-based Social Sciences Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Kehu Yang
- Evidence-based Social Sciences Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
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Yang Y, Lin Q, Ma L, Lai Z, Xie J, Zhang Z, Wu X, Luo W, Hu P, Wang X, Guo X, Lin H. Maternal fasting glucose levels throughout the pregnancy and risk of adverse birth outcomes in newborns: a birth cohort study in Foshan city, Southern China. Eur J Endocrinol 2023; 188:6986590. [PMID: 36680781 DOI: 10.1093/ejendo/lvac019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 11/28/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVE We aimed to investigate the associations between maternal fasting plasma glucose (FPG) levels and glycemic fluctuations during different trimesters and adverse birth outcomes among newborns. METHODS This cohort study used data from 63 213 pregnant women and their offspring in Foshan city from November 2015 to January 2019. Associations between maternal FPG and glycemic fluctuations during different trimesters and adverse birth outcomes [congenital heart defect (CHD), macrosomia, small/large for gestational age (SGA/LGA), and preterm birth (PTB)] in newborns were estimated using mixed-effects logistic regression models. RESULTS A total of 45 516 participants accepted at least one FPG test throughout pregnancy, and 7852 of whom had glycemic trajectory data. In the adjusted model, higher maternal FPG throughout the pregnancy was associated with an increased risk of adverse birth outcomes (except for SGA). Each 1 mmol/L increase in maternal FPG during trimester 1 was associated with higher odds of CHD (OR = 1.14 (95% CI: 1.02, 1.26)). The same increase in maternal FPG during trimester 3 was associated with a higher risk of PTB (OR = 1.05 (95% CI: 1.01, 1.10)). Increment of maternal FPG during trimester 2 and trimester 3 was associated with a higher risk of macrosomia and LGA. Increase in FPG throughout the pregnancy was associated with slightly lower odds of SGA. Similar results were observed when analyzing the associations between glycemic fluctuations during different trimesters and adverse birth outcomes. CONCLUSIONS Our findings indicate higher maternal FPG levels during different trimesters were associated with different adverse birth outcomes, which suggests the importance of glycemic management throughout the pregnancy.
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Affiliation(s)
- Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qingmei Lin
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan 528000, China
| | - Liming Ma
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan 528000, China
| | - Zhihan Lai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Junxing Xie
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan 528000, China
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xueli Wu
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan 528000, China
| | - Weidong Luo
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan 528000, China
| | - Pengzhen Hu
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan 528000, China
| | - Xing Wang
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan 528000, China
| | - Xiaoling Guo
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan 528000, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
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Zhang X, Xia Q, Lai Y, Wu B, Tian W, Miao W, Feng X, Xin L, Miao J, Wang N, Wu Q, Jiao M, Shan L, Du J, Li Y, Shi B. Spatial effects of air pollution on the economic burden of disease: implications of health and environment crisis in a post-COVID-19 world. Int J Equity Health 2022; 21:161. [PMCID: PMC9664438 DOI: 10.1186/s12939-022-01774-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 10/12/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Air pollution has been identified as related to the diseases of susceptible population, but the spatial heterogeneity of its economic burden and its determinants are rarely investigated. The issue is of great policy significance, especially after the epidemic of COVID-19, when human are facing the joint crisis of health and environment, and some areas is prone to falling into poverty.
Methods
The geographical detector was adopted to study the spatial distribution characteristics of the incidence of catastrophic health expenditure (ICHE) for older adults in 100 rural areas in China at the prefecture-city level. The health factors, sociological factors, policy factors and environmental factors and their interactions are identified.
Results
First, most health service factors had strong explanatory power for ICHE whether it interacts with air pollution. Second, 50 single-factor high-risk areas of ICHE were found in the study, but at the same time, there were 21 areas dominated by multiple factors.
Conclusion
The different contributions and synergy among the factors constitute the complex mechanism of factors and catastrophic health expenditure. Moreover, during this process, air pollution aggravates the contribution of health service factors toward ICHE. In addition, the leading factors of ICHE are different among regions. At the end, this paper also puts forward some policy suggestions from the perspective of health and environment crisis in the post-COVID-19 world: environmental protection policies should be combined with the prevention of infectious diseases; advanced health investment is the most cost-effective policy for the inverse health sequences of air pollution and infectious diseases such as coronavirus disease 2019 (COVID-19); integrating environmental protection policy into healthy development policy, different regions take targeted measures to cope with the intertwined crisis.
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Zhou W, Ming X, Chen Q, Liu X, Yin P. The acute effect and lag effect analysis between exposures to ambient air pollutants and spontaneous abortion: a case-crossover study in China, 2017-2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:67380-67389. [PMID: 35522417 PMCID: PMC9492619 DOI: 10.1007/s11356-022-20379-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/18/2022] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Recent studies demonstrated that living in areas with high ambient air pollution may have adverse effects on pregnancy outcomes, but few studies have investigated its association with spontaneous abortion. Further investigation is needed to explore the acute effect and lag effect of air pollutants exposure on spontaneous abortion. OBJECTIVE To investigate the acute effect and lag effect between exposure to ambient air pollutants and spontaneous abortion. METHODS Research data of spontaneous abortion were collected from the Chongqing Health Center for Women and Children (CQHCWC) in China. The daily ambient air pollution exposure measurements were estimated for each woman using inverse distance weighting from monitoring stations. A time-stratified, case-crossover design combined with distributed lag linear models was applied to assess the associations between spontaneous pregnancy loss and exposure to each of the air pollutants over lags 0-7 days, adjusted for temperature and relative humidity. RESULTS A total of 1399 women who experienced spontaneous pregnancy loss events from November 1, 2016, to September 30, 2019, were selected for this study. Maternal exposure to particulate matter 2.5 (PM2.5), particle matter 10 (PM10) nitrogen dioxide (NO2), and sulfur dioxide (SO2) exhibited a significant association with spontaneous abortion. For every 20 μg/m3 increase in PM2.5, PM10, NO2, and SO2, the RRs were 1.18 (95% CI: 1.06, 1.34), 1.12 (95% CI, 1.04-1.20), 1.15 (95% CI: 1.02, 1.30), and 1.92 (95% CI: 1.18, 3.11) on lag day 3, lag day 3, lag day 0, and lag day 3, respectively. In two-pollutant model combined with PM2.5 and PM10, a statistically significant increase in spontaneous abortion incidence of 18.0% (RR = 1.18, 95% CI: 1.06, 1.32) was found for a 20 μg/m3 increase in PM2.5 exposure, and 11.2% (RR = 1.11, 95% CI: 1.03, 1.20) for a 20 μg/m3 increase in PM10 exposure on lag day 3, similar to single-pollutant model analysis. CONCLUSION Maternal exposure to high levels of PM2.5, PM10, NO2, and SO2 during pregnancy may increase the risk of spontaneous abortion for acute effects and lag effects. Further research to explore sensitive exposure time windows is needed.
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Affiliation(s)
- Wenzheng Zhou
- Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Xin Ming
- Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Qing Chen
- Institute of Toxicology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Xiaoli Liu
- Chongqing Health Center for Women and Children, Chongqing, 401147, China.
| | - Ping Yin
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Zhang H, Zhang X, Zhang H, Luo H, Feng Y, Wang J, Huang C, Yu Z. Assessing the effect of fine particulate matter on adverse birth outcomes in Huai River Basin, Henan, China, 2013-2018. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119357. [PMID: 35489530 DOI: 10.1016/j.envpol.2022.119357] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 03/25/2022] [Accepted: 04/21/2022] [Indexed: 06/14/2023]
Abstract
Previous studies have indicated that maternal exposure to particles with aerodynamic diameter <2.5 μm (PM2.5) is associated with adverse birth outcomes. However, the critical exposure windows remain inconsistent. A retrospective cohort study was conducted in Huai River Basin, Henan, China during 2013-2018. Daily PM2.5 concentration was collected using Chinese Air Quality Reanalysis datasets. We calculated exposures for each participant based on the residential address during pregnancy. Binary logistic regression was used to examine the trimester-specific association of PM2.5 exposure with preterm birth (PTB), low birth weight (LBW) and term LBW (tLBW), and we further estimated monthly and weekly association using distributed lag models. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for each 10 μg/m3 increase in PM2.5 exposure. Stratified analyses were performed by maternal age, infant gender, parity, and socioeconomic status (SES). In total, 196,780 eligible births were identified, including 4257 (2.2%) PTBs, 3483 (1.8%) LBWs and 1770 (0.9%) tLBWs. Maternal PM2.5 exposure during the second trimester were associated with the risk of PTB and LBW. At the monthly level, the PTB and LBW risks were associated with PM2.5 exposure mainly in the 4th -6th month. By estimating the weekly-specific association, we observed that critical exposure windows of PM2.5 exposure and PTB were in the 18th- 27th gestational weeks. Stronger associations were found in younger, multiparous mothers and those with a female baby and in low SES. In conclusion, the results indicate that maternal PM2.5 exposure during the second trimester was associated with PTB and LBW. Younger, multiparous mothers and those with female babies and in low SES were susceptible.
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Affiliation(s)
- Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaoan Zhang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Han Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Hongyan Luo
- Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Yang Feng
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jingzhe Wang
- MNR Key Laboratory for Geo-Environmental Monitoring of Great Bay Area & Guangdong Key Laboratory of Urban Informatics & Shenzhen Key Laboratory of Spatial Smart Sensing and Services, Shenzhen University, Shenzhen, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou, China; National Health Commission Key Laboratory of Birth Defects Prevention, Key Laboratory of Population Defects Prevention, Zhengzhou, China
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12
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Pan D, Liu S, Huang D, Zeng X, Zhang Y, Pang Q, Wu H, Tan HJJ, Liang J, Sheng Y, Qiu X. Effects of household environmental exposure and ventilation in association with adverse birth outcomes: A prospective cohort study in rural China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 822:153519. [PMID: 35101501 DOI: 10.1016/j.scitotenv.2022.153519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 12/27/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
Prenatal exposure to outdoor air pollution have been associated with birth outcomes. However, there is limited evidence on the adverse effects of household indoor air pollution worldwide, much less in rural areas of China. This study aimed to explore the associations of household environmental factors (primary cooking fuel, housing renovation, and home ventilation) with four adverse birth outcomes (preterm birth (PTB), small for gestational age (SGA), low birth weight (LBW), and term low birth weight (T-LBW)). We conducted a cohort study involving 10,324 pregnancies in women who delivered a live-born infant from 2015 to 2018 in Guangxi, China. Risk ratios and 95% confidence intervals (CI) were estimated with control for reproductive history, lifestyle, home environmental confounders, and other potential confounders. A total of 5.4% of the infants were PTB, 10.7% were SGA, 5.5% had LBW, and 3.0% had T-LBW. Household-use induction cookers as the primary cooking fuel during pregnancy was associated with SGA (RR = 1.31, 95% CI: 1.07-1.60), LBW (1.41, 1.09-1.82), and T-LBW(1.62, 1.16-2.26), as compared with household-use gas as the primary cooking fuel. Housing renovation within one year before pregnancy was associated with PTB (1.45, 1.06-1.98) and LBW (1.56, 1.17-2.09), while housing renovation during pregnancy was associated with a higher risk of SGA only in moderate home ventilation conditions (3.74, 1.69-8.28). Our findings suggested that household-use induction cookers as the primary cooking fuel increased the risks of SGA, LBW, and T-LBW. In addition, housing renovation within one year before pregnancy increased the risks of PTB and LBW. Proper home ventilation may reduce the effect on the association between housing renovation during pregnancy and SGA.
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Affiliation(s)
- Dongxiang Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Shun Liu
- Department of Child and Adolescent Health & Maternal and Child Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Dongping Huang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xiaoyun Zeng
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Yuanxiao Zhang
- Obstetrical Department, Pingguo Maternal and Child Health Hospital, Pingguo 531400, Guangxi, China
| | - Qiang Pang
- Department of Cardiology, Debao Maternal and Child Health Hospital, Debao 533700, Guangxi, China
| | - Huiping Wu
- Obstetrical Department, Jingxi People's Hospital, Jingxi 533800, Guangxi, China
| | - Hui Juan Jennifer Tan
- Yong Loo Lin School of Medicine, National University of Singapore, 117597 Singapore, Singapore
| | - Jun Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Yonghong Sheng
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xiaoqiang Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
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13
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Ahn D, Kim J, Kang J, Kim YH, Kim K. Congenital anomalies and maternal age: A systematic review and meta-analysis of observational studies. Acta Obstet Gynecol Scand 2022; 101:484-498. [PMID: 35288928 DOI: 10.1111/aogs.14339] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/31/2022] [Accepted: 02/11/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Several studies have reported on the maternal age-associated risks of congenital anomalies. However, there is a paucity of studies with comprehensive review of anomalies. We aimed to quantify the risk of birth defects in children born to middle-aged mothers compared with that in children born to young or older mothers. MATERIAL AND METHODS We classified maternal ages into three groups: young (<20 years old), middle (20-34 years old) and older age (≥35 years old). Observational studies that met our age criteria were eligible for inclusion. The articles searched using the Embase and MEDLINE databases were those published from 1989 to January 21, 2021. The Newcastle-Ottawa scale was used to assess the risk of bias. If heterogeneity exceeded 50%, the random effect method was used; otherwise, the fixed-effect method was used. Prospero registration number: CRD42021235229. RESULTS We included 15 cohort, 14 case-control and 36 cross-sectional studies. The pooled unadjusted odds ratio (95% CI) of any congenital anomaly was 1.64 (1.40-1.92) and 1.05 (0.95-1.15) in the older and young age groups, respectively (very low quality of evidence). The pooled unadjusted odds ratio of chromosomal anomaly was 5.64 (5.13-6.20) and 0.69 (0.54-0.88) in the older and young age groups, respectively. The pooled unadjusted odds ratio of non-chromosomal anomaly was 1.09 (1.01-1.17) and 1.10 (1.01-1.21) in the older and young age groups, respectively (very low quality of evidence). The incidence of abdominal wall defects was increased in children of women in the young maternal age group. CONCLUSIONS We identified that very low quality evidence suggests that women in the older maternal age group had increased odds of having children with congenital anomalies compared with those in the 20-34 year age group. There was no increase in odds of children with congenital anomalies in women of <20 year age group except for abdominal defects compared with those in the 20-34 year age group. The results stem from very low quality evidence with no adjustment of confounders.
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Affiliation(s)
- Damin Ahn
- School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Jieon Kim
- School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Junyeong Kang
- School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Yun Hak Kim
- Department of Biomedical Informatics, School of Medicine, Yangsan, Pusan National University, Gyeongsangnam-do, Republic of Korea.,Department of Anatomy, School of Medicine, Yangsan, Pusan National University, Gyeongsangnam-do, Republic of Korea.,Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Pusan National University Yangsan Hospital, Gyeongsangnam-do, Republic of Korea
| | - Kihun Kim
- Department of Occupational and Environmental Medicine, Kosin University Gospel Hospital, Busan, Republic of Korea
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14
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Su X, Zhang S, Lin Q, Wu Y, Yang Y, Yu H, Huang S, Luo W, Wang X, Lin H, Ma L, Zhang Z. Prenatal exposure to air pollution and neurodevelopmental delay in children: A birth cohort study in Foshan, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 816:151658. [PMID: 34785226 DOI: 10.1016/j.scitotenv.2021.151658] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/25/2021] [Accepted: 11/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Prenatal exposure to air pollution may have adverse effects on neurodevelopment in children, but epidemiological evidence remains inconclusive. OBJECTIVE To investigate the associations between prenatal air pollution exposure and neurodevelopmental delay. METHODS We conducted a birth cohort study based on pregnancy and birth registry in Foshan, China. Exposure to particulate matter of aerodynamic diameter < 1 μm, 2.5 μm, 10 μm (PM1, PM2.5, PM10), nitrogen dioxide (NO2) and sulfur dioxide (SO2) over pregnancy (trimester 1, 2, 3 and entire pregnancy) was estimated at each woman's residential address using spatial-temporal models. Neurodevelopmental assessment was performed by pediatricians using a five-domain scale and developmental quotient (DQ) was calculated as a global measure. Logistic regression models were used to investigate the associations between prenatal air pollution exposure and neurodevelopmental delay (DQ < 75) with adjustment for potential confounders. RESULTS We included 15,778 child-mother pairs in this analysis, including 1013 children with neurodevelopmental delay. We observed positive associations between prenatal exposure to air pollution and higher risk of neurodevelopmental delay in children. The adjusted odds ratios (ORs) per 10 μg/m3 elevation in PM1, PM2.5, PM10, NO2 and SO2 in entire pregnancy were 1.12 [95% confidence interval (CI): 1.01, 1.25], 1.15 (95% CI: 1.03, 1.29), 1.12 (95% CI: 1.02, 1.24), 1.06 (95% CI: 0.94, 1.19) and 1.58 (95% CI: 1.11, 2.23), respectively. The associations were more robust for trimester 1 and trimester 2, especially trimester 1. CONCLUSIONS Exposure to air pollution during pregnancy, especially early-to-mid pregnancy, was associated with increased risk of neurodevelopmental delay in young children, indicating its adverse neurodevelopmental effects in early-life stage.
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Affiliation(s)
- Xi Su
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qingmei Lin
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Yinling Wu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hong Yu
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Saijun Huang
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Weidong Luo
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Xing Wang
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Liming Ma
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China.
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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15
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Chen L, Wang X, Qian ZM, Sun L, Qin L, Wang C, Howard SW, Aaron HE, Lin H. Ambient gaseous pollutants and emergency ambulance calls for all-cause and cause-specific diseases in China: a multicity time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:28527-28537. [PMID: 34988821 DOI: 10.1007/s11356-021-18337-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Much attention has been paid to the health effects of ambient particulate matter pollution; the effects of gaseous air pollutants have not been well studied. Emergency ambulance calls (EACs) may provide a better indicator of the acute health effects than the widely used health indicators, such as mortality and hospital admission. We estimated the short-term associations between gaseous air pollutants [nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3)] and EACs for all-cause, cardiovascular, and respiratory diseases in seven Chinese cities from 2014 to 2019. We used generalized additive models and random-effects meta-analysis to examine the city-specific and pooled associations. Stratified analyses were conducted by age, sex, and season. A total of 1,626,017 EACs were observed for all-cause EACs, including 230,537 from cardiovascular diseases, and 96,483 from respiratory diseases. Statistically significant associations were observed between NO2 and EACs for all-cause diseases, while the effects of SO2 were positive, but not statistically significant in most models. No significant relationship was found between O3 and EACs. Specifically, each 10 μg/m3 increase in the 2-day moving average concentration of NO2 was associated with a 1.07% [95% confidence interval (CI): 0.40%, 1.76%], 0.76% (95% CI: 0.19%, 1.34%) and 0.06% (95% CI: -1.57%, 1.73%) increase in EACs due to all-cause, cardiovascular and respiratory diseases, respectively. Stratified analysis showed a larger effect of NO2 on all-cause EACs in the cold season [excess relative risk (ERR): 0.33% (95% CI: 0.05%, 0.60%) for warm season, ERR: 0.77% (95% CI: 0.31%, 1.23%) for cold season]. Our study indicates that acute exposures to NO2 might be an important trigger of the emergent occurrence of all-cause, cardiovascular and respiratory diseases, and this effect should be of particular concern in the cold season. Further policy development for controlling gaseous air pollution is warranted to reduce the emergent occurrence of cardiopulmonary diseases.
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Affiliation(s)
- Lan Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Liwen Sun
- Huairou District Center for Disease Control and Prevention, Beijing, 101400, China
| | - Lijie Qin
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Steven W Howard
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Hannah E Aaron
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Zhang H, Zhang X, Zhao X, Cheng G, Chang H, Ye X, Wang J, Yu Z, Wang Q, Huang C. Maternal exposure to air pollution and congenital heart diseases in Henan, China: A register-based case-control study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 229:113070. [PMID: 34920182 DOI: 10.1016/j.ecoenv.2021.113070] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/27/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Association between ambient air pollution and congenital heart diseases (CHDs) remains inconclusive, and the critical exposure windows has not been well studied. OBJECTIVES This case-control study aimed to assess the effect of ambient air pollution exposure on the risk of CHDs and the subtypes in Henan, China, and further to explore potential susceptible windows. METHODS Daily average particulate matter with an aerodynamic diameter of ≤2.5 µm (PM2.5) and ≤10 µm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3) were collected by Chinese Air Quality Reanalysis datasets. Binary logistic regression was used to examine trimester-specific associations between per 10 μg/m3 increase in air pollutants and CHDs as well as the major subtypes. Distributed lag models incorporating logistic regression were applied to explore weekly-specific associations. RESULTS A total of 196,069 singleton live births were included during 2013-2018, 643 CHDs were identified (3.3‰). We found that first and second trimester CO exposure increased overall CHDs risk, the adjusted odds ratio (aOR) and 95% confidence interval (CI) were 1.066 (1.010-1.125) and 1.065 (1.012-1.122). For CHDs subtypes, we observed that NO2 and CO in first trimester, PM2.5 and PM10 in the second trimester exposure were associated with the risk of atrial septal defect (ASD), the susceptible windows of air pollutants and ASD mainly occurred in the 1st- 6th gestational weeks. No positive association was observed for air pollution and tetralogy of Fallot. CONCLUSION Our findings suggest that ambient air pollution exposure is associated with the risk of CHDs especially for ASD, and the susceptible windows generally occurred in first trimester. Further well-designed longitudinal studies are warranted to confirm our findings.
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Affiliation(s)
- Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China; School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoan Zhang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guomei Cheng
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Chang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaofang Ye
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Jingzhe Wang
- MNR Key Laboratory for Geo-Environmental Monitoring of Great Bay Area & Guangdong Key Laboratory of Urban Informatics & Shenzhen Key Laboratory of Spatial Smart Sensing and Services, Shenzhen University, Shenzhen, China
| | - Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou, China.
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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17
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Yu G, Chen Y, Tang J, Lin Z, Zheng F, Zheng C, Zhou J, Su Q, Wu S, Li H. Meta-analyses of maternal exposure to atmospheric particulate matter and risk of congenital anomalies in offspring. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:55869-55887. [PMID: 34491504 DOI: 10.1007/s11356-021-16200-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
Congenital anomalies are the main causes of infant death and disability. Previous studies have suggested that maternal exposure to particulate matter is related to congenital malformation. However, the conclusions of this study remain controversial. Hence, meta-analyses were performed to assess the relationship between maternal exposure to particulate matter and the risk of congenital anomalies. The Medline, Embase, and Web of Science databases were systemically searched from inception until August 2020 to find articles related to birth defects and particulate matter. The pooled risk estimated for the combination of pollution outcomes was calculated for each study by performing fixed effects or random effects models. The existence of heterogeneity and publication bias in relevant studies was also examined. Thirty studies were included in the analysis. A statistically increased summary risk valuation was found. PM10 exposure was associated with an increased risk of congenital heart disease, neural tube defects, and cleft lip with or without cleft palate (OR per 10 μg/m3 = 1.05, 95% CI, 1.03-1.07; OR per 10 μg/m3 = 1.04, 95% CI, 1.01-1.06; OR per 10 μg/m3 = 1.03, 95% CI, 1.01-1.06). Maternal exposure to particulate matter might be associated with an increased risk of congenital anomalies. Our results indicate the dangers of particulate matter exposure on fetal development and the importance of protection against exposure to such particles during pregnancy. The schematic representation of the association between maternal exposure to PM2.5/PM10 and congenital anomalies in offspring, and geographic distribution of the included reports in the meta-analyses.
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Affiliation(s)
- Guangxia Yu
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
- Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yao Chen
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Jianping Tang
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Zhifeng Lin
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Fuli Zheng
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
- Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Chunyan Zheng
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Jinfu Zhou
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
- Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Qianqian Su
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Siying Wu
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.
- Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China.
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Huangyuan Li
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
- Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China.
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Zhang Q, Sun S, Sui X, Ding L, Yang M, Li C, Zhang C, Zhang X, Hao J, Xu Y, Lin S, Ding R, Cao J. Associations between weekly air pollution exposure and congenital heart disease. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 757:143821. [PMID: 33248761 DOI: 10.1016/j.scitotenv.2020.143821] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The topic of congenital heart diseases (CHDs) has attracted more and more attentions. Accumulating evidence suggests that exposure to air pollutants during pregnancy is associated with CHDs, yet the results are inconsistent and study about weekly exposure is few. Our study evaluated the association between weekly air pollution and CHDs in Hefei, China. MATERIALS AND METHODS Daily CHDs admission data were obtained from eight hospitals in Hefei from October 2015 to September 2017. Meteorological data and air quality were collected from China Meteorological Data Network. Distributed lag nonlinear model (DLNM) considering both the lag effect of exposure factors and the nonlinear relationship of exposure-reaction was used to assess the effect of weekly air pollutants exposure on CHDs admission. RESULTS During the study period, totally 47,046 cases of perinatal infants were recruited, and the incidence of CHDs was 9.71 per thousand. The findings showed PM2.5, PM10, SO2 and NO2 significantly increased the risk of CHDs. Each 10 μg/m3 increase in PM2.5 during gestational weeks 20-26 increased the risk of CHDs. The susceptibility windows of PM10 (weeks 0-2 and weeks 25-29 of pregnancy), SO2 (weeks 8-16 and weeks 29-38) and NO2 (week 40), while the strongest effects of these 4 pollutants on CHDs were observed in week 22 (RR = 1.034, 95% CI: 1.007-1.062), week 0 (RR = 1.081, 95% CI: 1.02-1.146), week 37 (RR = 1.528, 95% CI: 1.085-2.153) and week 40 (RR = 1.171, 95% CI: 1.006-1.364), respectively. CONCLUSIONS Air pollutants (SO2, NO2, PM10, and PM2.5) exposure could increase the risk of CHDs, while the most crucial susceptibility windows for the exposure were mainly in the second and third trimesters. Boys seemed to be more sensitive to air pollution. Our study contributes to the knowledge of the association between maternal exposure to air pollution and CHDs, but the associations need to be verified by further studies.
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Affiliation(s)
- Qi Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Shu Sun
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Xinmiao Sui
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Liu Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Mei Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Changlian Li
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Chao Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
| | - Xiujun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
| | - Jiahu Hao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
| | - Yuechen Xu
- Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Shilei Lin
- Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Jiyu Cao
- Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
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Neven KY, Wang C, Janssen BG, Roels HA, Vanpoucke C, Ruttens A, Nawrot TS. Ambient air pollution exposure during the late gestational period is linked with lower placental iodine load in a Belgian birth cohort. ENVIRONMENT INTERNATIONAL 2021; 147:106334. [PMID: 33360673 PMCID: PMC7816215 DOI: 10.1016/j.envint.2020.106334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Adequate intake of iodine is required for the production of thyroid hormones and contributes in pregnant women to a healthy brain development and growth in their offspring. To date, some evidence exists that fine particulate air pollution is linked with the fetal thyroid hormone homeostasis. However, possible effects of air pollutants on the placental iodine storage have not been investigated so far. OBJECTIVES We investigated the association between air pollution exposure to particulate matter with a diameter less than 2.5 µm (PM2.5), NO2, and black carbon and the placental iodine load. METHODS The current study is part of the ENVIRONAGE birth cohort and included 470 mother-newborn pairs. Iodine concentrations were measured in placental tissue. A high-resolution air pollution model was used to estimate the daily exposure to PM2.5, NO2, and black carbon over the entire pregnancy based on the maternal residential addresses. Distributed lag nonlinear models (DLNMs) were used to estimate gestational week-specific associations between placental iodine concentrations and the air pollutants to understand the impact of specific exposure windows. RESULTS PM2.5 showed a positive association with placental iodine concentration between the 16th and 22nd week of gestation. In contrast, a significant inverse association between PM2.5 and placental iodine concentration was observed in gestational weeks 29-35. The effect estimate, for a 5 µg/m3 increment in PM2.5 concentration, was the strongest at week 32 (β -0.11 µg/kg; 95%CI: -0.18 to -0.03). No associations were observed between placental iodine concentrations and NO2 or black carbon. Assuming causality, we estimated that placental iodine mediated 26% (-0.33 pmol/L; 95%CI: -0.70 to 0.04 pmol/L) of the estimated effect of a 5 µg/m3 increment in PM2.5 exposure on cord blood free thyroxine (FT4) concentrations. CONCLUSION In utero exposure to particulate matter during the third trimester of pregnancy is linked with a lower placental iodine load. Furthermore, the effect of air pollution on cord blood FT4 levels was partially mediated by the placental iodine load.
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Affiliation(s)
- Kristof Y Neven
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Congrong Wang
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Bram G Janssen
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Louvain Centre for Toxicology and Applied Pharmacology, Université catholique de Louvain, Brussels, Belgium
| | | | - Ann Ruttens
- SD, Chemical, and Physical Health Risks, Sciensano, Tervuren, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Department of Public Health and Primary Care, Leuven University, Leuven, Belgium.
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